Author: Angela Rufo, DO, MS
Co Author #1: Angela Rufo DO
Co Author #2: Elizabeth Rothe MD
Senior Editor: Carolyn Landsberg, MD
Editor: Jacob Miller, MD

Patient Presentation:
A 22-year-old male collegiate football player with no past medical history presented with neck clicking for two weeks.

History:
The patient stated that his symptoms began when he was hit by another player during football practice. There was no direct contact made with his head or neck. He reported his chinstrap pulled his chin superiorly. The patient continued to play and was evaluated by the athletic trainers at the end of practice for a clicking sensation. At that time, his exam was unremarkable except for neck clicking while swallowing. Two days later, the patient stated the neck clicking persisted and occurred intermittently when he swallowed. He was able to tolerate a liquid and solid diet. The clicking would resolve after a few bites of food during every meal. He denied fever, chills, dysphagia, sore throat, drooling, ear pain, tinnitus, shortness of breath, nausea, vomiting, tongue swelling, subcutaneous edema, erythema, ecchymosis, or neck pain.

Physical Exam:
General - Well appearing, no acute distress. Speech: normal voice, speaking in full sentences
Head - Normocephalic, atraumatic. Jaw: no deviation or clicking palpated along the jawline or temporomandibular joint
Throat - symmetric, non erythematous, no purulent discharge, airway patent
Neck - No erythema, edema, scars, or deformities. No audible stridor. No tenderness or nodules palpated over thyroid, cricothyroid, trachea, sternocleidomastoid, trapezius, or hyoid. Popping sensation on left anterolateral region with palpation during swallowing. Full range of motion of cervical spine.
Lymph: No cervical lymphadenopathy

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